Smokers turn to 'vaping' to give up the habit

Alyson War, Houston Chronicle

By Alyson Ward

Published 6:38 pm, Tuesday, August 20, 2013

A person poses with an electronic cigarette, or e-cigarette, Wednesday June 12, 2013, after it was announced that Britain will start regulating electronic cigarettes as medicines, according to the country's top regulator, the Medicines and Healthcare Products Regulatory Agency. E-cigarettes are battery-operated products that turn nicotine into a vapor that is inhaled by the user, and the new regulations coming into force from 2016 will control products containing nicotine as medications, but normal cigarettes are exempt from the regulation. (AP Photo / Tim Ireland, PA) UNITED KINGDOM OUT - NO SALES - NO ARCHIVES
Photo: Tim Ireland, SUB

A person poses with an electronic cigarette, or e-cigarette,...

Craig Ferguson uses his electronic cigarette at the Fox and Hound Bar and Grill Saturday August 17, 2013 in Houston, TX. A local group, The Houston Vapers, get together once a month to share the latest on electronic cigarettes. (Michael Starghill, Jr)
Photo: Michael Starghill, Jr., Photographer

Craig Ferguson uses his electronic cigarette at the Fox and Hound...

Hudson Hallenbeck (left), Ken Burkhardt (center) and Craig Ferguson use their electronic cigarettes at the Fox and Hound Bar and Grill Saturday August 17, 2013 in Houston, TX. A local group, The Houston Vapers, get together once a month to share the latest on electronic cigarettes. (Michael Starghill, Jr)
Photo: Michael Starghill, Jr., Photographer

Craig Ferguson uses his electronic cigarette at the Fox and Hound Bar and Grill Saturday August 17, 2013 in Houston, TX. A local group, The Houston Vapers, get together once a month to share the latest on electronic cigarettes. (Michael Starghill, Jr)
Photo: Michael Starghill, Jr., Photographer

Craig Ferguson uses his electronic cigarette at the Fox and Hound...

Ken Burkhardt, left, and Craig Ferguson use electronic cigarettes at the Fox and Hound Bar and Grill, where the Houston Vapers often get together to share the latest in electronic cigarettes.
Photo: Michael Starghill, Jr., Photographer

Ken Burkhardt, left, and Craig Ferguson use electronic cigarettes...

Hudson Hallenbeck (left), Ken Burkhardt (center) and Craig Ferguson use their electronic cigarettes at the Fox and Hound Bar and Grill Saturday August 17, 2013 in Houston, TX. A local group, The Houston Vapers, get together once a month to share the latest on electronic cigarettes. (Michael Starghill, Jr)
Photo: Michael Starghill, Jr., Photographer

A collection of electronic cigarettes at the Fox and Hound Bar and Grill Saturday August 17, 2013 in Houston, TX. A local group, The Houston Vapers, get together once a month to share the latest on electronic cigarettes. (Michael Starghill, Jr)
Photo: Michael Starghill, Jr., Photographer

"I went through the patches, the gum, the Chantix in a search to quit," she said. "None of it was working."

About four years ago, she tried electronic cigarettes. "I picked it up and didn't have another cigarette."

No longer a smoker, she's now a "vaper."

Instead of burning tobacco, battery-powered e-cigs heat up a flavored liquid, which delivers a dose of nicotine in a cloud of scentless water vapor. The products - which mimic the function of a cigarette without the odor and ash - have picked up steam in recent years, a result of celebrity endorsements and the fact that, for smokers like Cryer trying to put down the Marlboros, they have done the job. Electronic cigarettes are projected to become a billion-dollar industry this year.

Cryer, 33, helped organize the Houston Vapers Club, which meets monthly for members to sample and compare different liquids and vaping equipment. The August meeting attracted more than 100 vapers to a Fox and Hound restaurant, where they were allowed to "smoke" their e-cigs inside.

Most at the meeting were former smokers who used e-cigarettes to quit, Cryer said. They ranged in age from 18 to 80, "people in business suits and people with pink hair."

"We even try to invite smokers," said member Ken Burkhardt, who until a few months ago smoked about a pack of Camels a day. Converts want to spread the gospel of vaping, to convince others to give up tar and tobacco in favor of batteries and flavored nicotine.

E-cigs are sold in drugstores, supermarkets, wherever cigarettes are sold. They're also sold online.

Some look just like regular cigarettes; in fact, some are even disposable. The cigarette look-alikes are considered an entry-level product in the vaping community, Burk-hardt said; most of the regular vapers he knows have graduated to more sophisticated devices. He uses a ProVari with variable voltage and a tiny tank that holds a day's supply of the cinnamon-flavored liquid he prefers.

"When I switched to blu electronic cigarettes," she says in the ad, "… I felt the freedom to have a cigarette without the guilt."

But that notion - that e-cigarettes are healthy and guilt-free - is something that worries people in the medical field.

"They're marketed as a medical device, but they're not regulated as a medical device," said Dr. Rima Gidwani, a pulmonary critical care physician at Memorial Hermann and an assistant professor at the University of Texas Medical School at Houston.

Gidwani has patients who have chosen to vape to stop smoking cigarettes. But she's not willing to endorse the method.

"It's hard to recommend this to anybody," she said, "because I can't guarantee that my patient is getting something safe."

She presents the pros and cons to her patients and lets them decide.

Electronic cigarettes generally do deliver less nicotine than regular cigarettes, Gidwani said; some are even labeled "nicotine-free." And they certainly don't have as many of those carcinogens one inhales when smoking a cigarette - the tar and chemicals that lead to oral cancer, throat cancer and lung cancer.

Plus, an electronic cigarette lets users simulate the behavior of smoking a cigarette, and that can cut down cravings, Gidwani said. If you're emotionally addicted to the act of smoking, she said, "you may get some benefit just from picking up something that looks like a cigarette, putting it in your mouth and puffing it."

But it's not all good news. First, Gidwani said, you don't really know what you're inhaling when you smoke an electronic cigarette.

"The majority are manufactured in China, and there's absolutely no oversight in the way they're manufactured," Gidwani said. "There's no quality control."

Tests have shown that electronic cigarettes have plenty of impurities, she said. In 2009, the FDA tested two popular brands of e-cigarettes and flavor cartridges. The study found low levels of carcinogens in both brands, and some of the cartridges labeled nicotine-free actually contained small amounts of nicotine. And a small amount of diethylene glycol was detected in one product. The compound, used in antifreeze, is toxic to humans.

Although electronic cigarettes have been on the market for seven years, there hasn't yet been a major randomized controlled trial, Gidwani said - probably because product quality varies so widely from brand to brand and from batch to batch.

"The first step really has to be to institute some quality," she said. "Then you can spend the time, effort and money to do a study."

Smoking alternative

Burkhardt, 53, said he understands the concerns about e-cigarettes. "I went into it with a certain amount of skepticism," he said. But he's researched the issue and believes the unknowns are outweighed by the improvement he's seen in his health. After four months, he feels better and doesn't cough the way he used to.

Cryer, too, believes she has a healthier habit since she started vaping.

"I felt better almost instantly," Cryer said. "Within a week, I had no more of the wheezing and the smoker's cough. Within two-and-a-half weeks, the sense of smell and taste buds completely came back."

Burkhardt is paying attention as new research emerges. But he's decided that, for him, vaping is better than smoking a pack a day.

"If you don't use some common sense," he said, "almost anything can be dangerous."